Support means for diagnosing sepsis and the stages thereof require the detection and testing of a great variety of values and vital parameters (for example, hemodynamic values, respiration values, blood gas analysis values or other laboratory values or measured values of medical devices, for example, heart rate-measuring devices, etc.) at regular intervals. These measured values and sensor signals are typically acquired at different times and with different devices and are thus available in a distributed form (in the sense of information technology).
The following septic stages and statuses exist:    1. SIRS syndrome (Systemic Inflammatory Response Syndrome). This status is defined by at least two of the following criteria:            Fever or hypothermia, confirmed by rectal, intravascular or intravesical measurement,        Tachycardia with a heart rate above 90 beats per minute,        Tachypnea with a rate of 20 beats per minute, or hyperventilation (arterial partial pressure of CO2, PaCO2<4.3 kPa<33 mmHg)        Leukocytosis (>1,200 per mm3) or leukopenia (<4,000 per mm3) or >10% immature neutrophils in the differential blood count,            2. Sepsis, defined as SIRS as a response to an inflammatory process,    3. Severe sepsis, defined as sepsis with organ dysfunction or with tissue hypoperfusion, and    4. Septic shock as severe sepsis as well as a systolic arterial blood pressure of <90 mmHg for at least 1 hour.
The diagnosis of sepsis or a septic status is a highly complex, multistep process, which is based on a large number of different sensor data. There are guidelines for the prevention, diagnosis, therapy and aftercare of sepsis (for example, by the Deutsche Sepsisgesellschaft e. V. [German Sepsis Society, registered association], hereinafter also called DSG, and an equivalent in the USA, the Surviving Sepsis Campaign, SSC).
Current studies show that sepsis develops, as a rule, slowly and with only small changes in the vital parameters (usually in a time window of 24 hours), which are at times very difficult to notice. The detection of a septic status therefore often remains unnoticed. The mortality rates associated with a septic status are alarmingly high: 30% to 50% mortality rates for severe sepsis and 50% to 60% for septic shock can be noted. If a septic status remains undetected and thus untreated, this consequently means a dramatic worsening of the patient's status. Conversely, the sooner therapeutic measures can be taken, the better are the chances for the affected patient.
Various systems are known in the state of the art in the device-based, preparatory support for diagnosing a septic status. Thus, especially the “Eventmanager” system MetaVision of the firm of imdSoft, and the “Clinical Advisories” system “IntelliVue” of the firm of Phillips are known. Both systems are also used to diagnose sepsis and are implemented in a patient data management system. The user can configure a rule engine in order to make possible the automatic detection of changes in the patient's status by means of the product. A tabular view (“flow sheet”) is displayed with a curve showing the changes in the measured values over time. The user disadvantageously does not receive any information or any display of previous measured values and previous statuses (concerning the “Clinical Advisories” system).
Furthermore, it proved to be disadvantageous in practice that the user can obtain the necessary information only by clicks and a review of several views on the user interface. Furthermore, the normal range for the respective signals and parameters is not always outputted (graphically), which makes the operation of the system, on the whole, difficult, and may sometimes cause life-preserving measures to be initiated too late.
It is important for a user to obtain information on the sepsis-relevant data sets as rapidly and in as clear a form as possible. In addition, it should be visible in a short time and quasi at a glance where or in which patient there is a detailed need for action (for example, in the form of the acquiring further sensor data or in the form of the initiation of therapeutic measures).
It is also desirable to sort and/or filter according to the different degrees of severity of a sepsis (septic status) and according to the confirmation of a septic status that has yet to be made. Furthermore, the signal data or parameter values that are being monitored and/or are (still) missing shall be identified.
Another system known in the state of the art is the “Protocol Watch” system of the firm of Philips. This system also displays parameters that are important for the diagnosis of sepsis. The normal values or permissible values are likewise visualized with the current values during the visualization of this system. One drawback of this system can, however, be seen in the fact that the display of graphic curves describing the signals is limited only to 12 hours.
Furthermore, the selection of the displayed values is fixed and hence limited. Another considerable drawback can be seen in that the user does not obtain any information on the extent to which noncompliance with limit values of a parameter affects the assessment of sepsis and on the extent to which the exceeding of a limit possibly interacts with other parameter values. Since further measures are, as a rule, time-critical and rapid acquiring of sepsis-relevant data sets is indispensable, it is desirable to have a graphic display of the relevant data sets in an overview display.